Combination therapy of ranibizumab and photodynamic therapy for retinal angiomatous proliferation with serous pigment epithelial detachment in Korean patients: twelve-month results.

PURPOSE

The purpose of this study was to evaluate the safety and efficacy of combination therapy with intravitreal ranibizumab and photodynamic therapy in the treatment of retinal angiomatous proliferation (RAP) with serous pigment epithelial detachment.

METHODS

Ten eyes of nine consecutive patients with newly diagnosed RAP were enrolled in this prospective pilot study. A course of combination therapy consisted of three ranibizumab injections at monthly intervals and a single photodynamic therapy, guided by indocyanine green angiography, about 1 week after the first injection. The patients were followed every month for 12 months. Retreatment was administered when a persistent, recurrent, or new RAP lesion was confirmed.

RESULTS

Eight of the 9 patients (9 eyes) completed 12 months of follow-up. At the 3-month visit, 8 of the 9 eyes (89%) showed favorable initial responses. After 6 months, recurrent lesions developed in 2 eyes (25%) and a new lesion in one other eye; all showed favorable responses to retreatment. At the 12-month visit, 7 eyes (78%) showed regression of the RAP lesions, among which 5 eyes (56%) required only a single session of combination treatment. The mean best-corrected visual acuity was improved from 20/125 at baseline to 20/63 (P = 0.021), and the mean central foveal thickness was reduced from 353 μm at baseline to 169 μm (P = 0.017). The mean improvement in the best-corrected visual acuity was 3.86 lines. No patient had vision-threatening adverse events.

CONCLUSION

Ranibizumab and photodynamic therapy combination therapy appears to be safe and effective for anatomical and functional improvement in patients with RAP with pigment epithelial detachment. Further evaluation with a larger patient sample and a long-term controlled study is required to compare treatment efficacy with antivascular endothelial growth factor monotreatment.